緊急気道管理を要した巨大縦隔内甲状腺腫の1例

Giant Intrathoracic Goiter Requiring Emergency Airway Management；Report of a Case

はじめに　縦隔内甲状腺腫は腫瘍全体あるいは50％以上が縦隔内に存在するものである1）．2014年の日本胸部外科学会の報告では，本邦の縦隔腫瘍切除例4,685例中75例（1.6％）と少数である2）．一方，緩徐に発育するため無症状の場合が多いが，巨大化すると気道を圧排し呼吸不全をきたす可能性がある．われわれは呼吸困難で発見され，緊急気道管理の後に手術を行った巨大縦隔内甲状腺腫の1手術例を経験した．

An 81-year-old woman with acute respiratory distress was referred to our hospital. Computed tomo-graphy showed a large mass in the upper mediastinum with severe tracheal stenosis. Endotracheal intubation was performed under the preparation of extracorporeal membrane oxygenation and high-frequency jet ventilation, and the tumor was completely removed. The pathologic diagnosis was a goiter. Post-operatively, respiratory distress disappeared. No tumor recurrences have been noted for more than 2 years after surgery.